doxazosin (Cardura)
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Introduction
Tradename: Cardura. An alpha-1 adrenergic receptor antagonist.
Indications
* ok for treatment of hypertension with comorbid BPH in the elderly despite results of ALLHAT study[6]
Contraindications
Dosage
start 1 mg PO QD, max 16 mg/day
Tabs: 1, 2, 4, 8 mg.
Adverse effects
- orthostatic hypotension
- reflex tachycardia
- precipitation of heart failure?[3]*
- development of tolerance
- dizziness
- nasal congestion
- stress urinary incontinence, especially in women with pelvic organ prolapse[6]
* in the ALLHAT study, the doxazosin arm was discontinued early due to a high incidence of heart failure[3]
- drug adverse effects of alpha-1 adrenergic receptor antagonists
- drug adverse effects of antihypertensive agents
Mechanism of action
- alpha-1 adrenergic receptor antagonist
- reduces total peripheral resistance through both arterial & venous dilation
- increases urine flow in BPH by relaxing smooth muscle tone in the bladder neck of the prostate
- relaxes internal urethral sphincter*
- enhances glycolysis[5]
- may improve glucose tolerance with long-term therapy
- may lower risk of Parkinson's disease (RR=0.88)[5]
* may increase risk of stress urinary incontinence[6]
More general terms
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Jump up to: 3.0 3.1 3.2 Prescriber's Letter 8(7):38 2001
Journal Watch 23(3):21, 2003 Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002 Dec 18;288(23):2981-97. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12479763
The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) http://www.nhlbi.nih.gov/health/allhat/index.htm - ↑ Jump up to: 4.0 4.1 Deprecated Reference
- ↑ Jump up to: 5.0 5.1 5.2 Simmering JE, Welsh MJ, Liu L et al Association of Glycolysis-Enhancing alpha-1 Blockers With Risk of Developing Parkinson Disease. JAMA Neurol. 2021;78(4):407-413. Feb 1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33523098 PMCID: PMC7851758 Free PMC article https://jamanetwork.com/journals/jamaneurology/fullarticle/2775976
- ↑ Jump up to: 6.0 6.1 6.2 6.3 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ Department of Veterans Affairs, VA National Formulary